Abstract
Although it is recognized that psychosocial variables influence the expression of psychopathology following trauma exposure, physiological variables have received less attention as potential mediators of psychological outcome in trauma victims. The purpose of this study was to examine the relationship of head injury to psychological outcome in 171 combat veterans seeking compensation for service-connected disabilities for mental disorders attributed to etiologies other than head injury. Veterans underwent structured psychiatric diagnostic interview and completed self-report measures of combat exposure, posttraumatic stress disorder (PTSD), depression, and occurrence of head injury. Comparisons between veterans with and without history of head injury indicated that head injury was associated with more severe depression. Regression analysis suggested that head injury predicted depression, but not PTSD, severity.
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Beck, A., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. K. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
Cassiday, K. L., & Lyons, J. A. (1992). Recall of traumatic memories following cerebral vascular accident. Journal of Traumatic Stress, 5, 627–631.
Chemtob, C. M., Muraoka, M. Y., Wu-Holt, P., Fairbank, J. A., Hamada, R. S., & Keane, T. M. (1998). Head injury and combat-related posttraumatic stress disorder. The Journal of Nervous and Mental Disease, 186, 701–708.
Eisenberg, H. M., & Levin, H. S. (1989). Computed tomography and magnetic resonance imaging in mild to moderate head injury. In H. S. Levin, H. M. Eisenberg, & A. L. Benton (Eds.), Mild head injury (pp. 133–141). New York: Oxford University Press.
Fairbank, J. A., Hansen, D. J., & Fitterling, J. M. (1991). Patterns of appraisal and coping across different stressor conditions among former prisoners ofwar with and without post-traumatic stress disorder. Journal of Consulting and Clinical Psychology, 59, 274–281.
First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B.W. (1996). Structured Clinical Interview for DSM-IV. New York: Biometrics Research, New York State Psychiatric Institute.
Friedman, M. J., Charney, D. S., & Deutch, A. Y. (1995). Neurobiological and clinical consequences of stress: From normal adaptation to posttraumatic stress disorder. Philadelphia: Lippincott-Raven.
Goldfeld, A. E., Mollica, R. F., Pesavento, B. H., & Faraone, S. V. (1988). The physical and psychological effects of torture: Symptomatology and diagnosis. Journal of the American Medical Association, 259, 2725–2729.
Hardaway, R. M. (1978). Viet Nam wound analysis. The Journal of Trauma, 18, 635–643.
Hillbom, M., & Holm, L. (1986). Contributions of traumatic head injuries to neuropsychological deficits in alcoholics. Journal of Neurology, Neurosurgery, and Psychiatry, 49, 1348–1353.
Holahan, C. J., & Moos, R. H. (1991). Life stressors, personal and social resources, and depression: A 4-year structural model. Journal of Abnormal Psychology, 100, 31–38.
Keane, T. M., Caddell, J. M., & Taylor, K. L. (1988). Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85–90.
Keane, T. M., Fairbank, J. A., Caddell, J. M., Zimmering, R. T., Taylor, K. L., & Mora, C. A. (1989). Clinical evaluation of a measure to assess combat exposure. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1, 53–55.
Knight, J. A. (1997). Neuropsychological assessment in posttraumatic stress disorder. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma in PTSD (pp. 448–492). New York: Guilford.
Kulka, R. A., Schlenger, W. E., Fairbank, J. A., Hough, R. L., Jordan, B. K., Marmar, C. R., & Weiss, D. S. (1990). Trauma and the Vietnam War generation: Report of findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel.
Lezak, M. (1987). Relationships between personality disorders, social disturbances, and physical disability following traumatic brain injury. Journal of Head Trauma Rehabilitation, 2, 57–69.
Macklin, M. L., Metzger, L. J., Litz, B. T., McNally, R. J., Lasko, N. B., Orr, S. P., & Pitman, R. K. (1998). Lower precombat intelligence is a risk factor for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 66, 323–326.
McFarlane, A. C., & Yehuda, R. (1993). Resilience, vulnerability, and the course of posttraumatic reactions. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience in mind, body, and society (pp. 155–181). NewYork: Guilford.
McLean, A., Dikmen, S. S., & Temkin, N. R. (1993). Psychosocial recovery after head injury. Archives of Physical Medicine and Rehabilitation, 74, 1041–1046.
Newcombe, F. (1996). Very late outcome after focal wartime brain wounds. Journal of Clinical and Experimental Neuropsychology, 18, 1–23.
Salazar, A. M., Schwab, K., & Grafman, J. H. (1995). Penetrating injuries in theVietnamWar:Traumatic unconsciousness, epilepsy, and psychosocial outcome. Neurosurgery Clinics of North America, 6, 715–726.
Schnurr, P. P., Rosenberg, S. D., & Friedman, M. J. (1993). Change in MMPI scores from college to adulthood as a function of military service. Journal of Abnormal Psychology, 102, 288–296.
Slagle, D. A. (1990). Psychiatric disorders following closed head injury: An overview of biopsychosocial factors in their etiology and management. International Journal of Psychiatry in Medicine, 20, 1–35.
Starkstein, S., Pearlson, G., Boston, J., & Robinson, R. (1987). Mania after brain injury: A controlled study of causative factors. Archives of Neurology, 44, 1069–1073.
Varney, N. R., Bushnell, D. L., Nathan, M., Kahn, D., Roberts, R., Rezai, K., Walker, W., & Kirchner, P. (1995). NeuroSPECT correlates of disabling mild head injury: Preliminary findings. Journal of Head Trauma Rehabilitation, 10, 18–28.
Varney, N., Martzke, J., & Roberts, R. (1987). Major depression in patients with closed head injury. Neuropsychology, 1, 7–9.
Varney, N. R., & Menefee, L. (1993). Psychosocial and executive deficits following closed head injury: Implications for orbital frontal cortex. Journal of Head Trauma Rehabilitation, 8, 32–44.
Vasterling, J. J., Brailey, K., Constans, J. I., Borges, A., & Sutker, P.B. (1997). Assessment of intellectual resources in Gulf War veterans: Relationship to PTSD. Assessment, 4, 51–59.
Wolfe, J., & Charney, D. S. (1991). Use of neuropsychological assessment in posttraumatic stress disorder. Psychological Assessment:AJournal of Consulting and Clinical Psychology, 3, 573–580.
Wolfe, J., Keane, T. M., Kaloupek, D. G., Mora, C. A., & Wine, P. (1993). Patterns of positive stress adjustment in Vietnam combat veterans. Journal of Traumatic Stress, 6, 179–193.
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Vasterling, J.J., Constans, J.I. & Hanna-Pladdy, B. Head Injury as a Predictor of Psychological Outcome in Combat Veterans. J Trauma Stress 13, 441–451 (2000). https://doi.org/10.1023/A:1007781107513
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DOI: https://doi.org/10.1023/A:1007781107513